Awareness and practice of Revised Code of Dental Ethics and Consumer Protection Act among dental practitioners in Andhra Pradesh: A cross sectional study.

BACKGROUND: Given the imperative for dental practitioners to be familiar with the existing ethical principles and laws governing their practice, this study aimed to evaluate awareness and practice of the dentists (code of ethics) regulations 2014 and consumer protection act 2019 among dental practitioners in Andhra Pradesh state, India. METHODS: A cross sectional study was conducted among 384 dental practitioners in Andhra Pradesh state, India. A questionnaire consisting of 25 items was used to assess awareness and practice of the dentists (code of ethics) regulations and consumer protection act. The data collected were analysed using IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp. RESULTS: Only 53(13.8%) dental practitioners in the study were aware that the dentists (code of ethics) regulations had been revised in 2014. About 190 (49.5%) practitioners were aware of the precise period for mandatory preservation of patient records. Most dental practitioners (278, 72.4%) accepted commissions in the form of gifts or cash from laboratories, radiologists, or pharmacists and 306 (79.7%) dental practitioners used unregistered dental lab technicians as employees in their practice. Furthermore, 297 (77.3%) practitioners were found to provide or sell drugs to patients in their clinic/office. The new regulations under consumer protection act 2019 were unknown to 194 (50.5%) dental practitioners. CONCLUSIONS: The present study indicates that the awareness of dental practitioners towards the dentists (code of ethics) regulations 2014 and consumer protection act 2019 is inadequate. It highlights the need for training programmes and curriculum changes with a focus on ethical and legal issues in clinical dental practice.

Comparison of the effectiveness of DFDBA and T-PRF in the regeneration of intra-bony defects- A randomized split-mouth study.

OBJECTIVES: This research intended to compare and evaluate the effectiveness of titanium-prepared platelet-rich fibrin (T-PRF) over demineralized freeze-dried bone allograft (DFDBA) in treating intra-bony defects based on the clinical and radiographic criteria. METHODS: This is a prospective randomized controlled, single-blinded split-mouth study where 15 patients with 30 intrabony defects were included. Subjects were randomly divided into T-PRF and DFDBA groups respectively. Plaque index (PI), Gingival index (GI), Probing pocket depth (PPD), Relative- clinical attachment- level (R-CAL), Defect depth, Linear amount of bone fill, Percentage of bone fill, Defect angle were assessed at baseline, 3, 6, and 9 months. For intra- and inter-group comparisons, paired and unpaired t-tests were executed. P<0.05 was set as statistically significant. RESULTS: There were statistically significant differences (P<0.05) in clinical and radiographic parameters in both T-PRF and DFDBA groups from baseline values to 9 months in intragroup comparisons. However, on intergroup comparison, no statistical significance was seen. CONCLUSION: The clinical parameters and radiographic outcomes showed marked improvement at 9 months with both T-PRF and DFDBA in the treatment of intrabony defects from baseline values. CLINICAL RELEVANCE: T-PRF has shown favorable results that are comparable to DFDBA for the treatment of intrabony periodontal defects.

Clinical and patient-reported outcomes of periodontal phenotype modification therapy using injectable platelet rich fibrin with microneedling and free gingival grafts: A prospective clinical trial.

BACKGROUND: To evaluate the clinical non-inferiority of injectable platelet-rich fibrin and micro-needling (iPRF+MN) with free gingival grafting (FGG) in periodontal phenotype modification therapy. METHODOLOGY: Twenty participants with a gingival thickness (GT)<0.8 mm in the mandibular anterior region were included. The participants were randomly allocated into i-PRF+MN and FGG groups. i-PRF injection was done, and MN was done with the help of a lancet in the i-PRF+MN group. The clinical parameters, i.e., GT and Keratinized tissue width (KTW), were evaluated at baseline, 3 and 6 months post-operatively. Patient-reported outcomes (PROs), i.e., discomfort and esthetic satisfaction, were assessed using the visual analogue score(VAS) at one week and 3 months of re-evaluation, respectively. RESULTS: Both groups showed a significant increase in GT and KTW with no intergroup variation (P-0.32, 0.48respectively) at the end of 6 months. However, the i-PRF+ MN group showed better PROs, i.e., less discomfort(1.11±0.60) and better esthetic satisfaction(8.77±0.44). CONCLUSION: The non-invasive treatment of i-PRF+MN may lead to non-inferior clinical outcomes after 6 months with better PROs compared to more invasive FGG protocols in phenotype modification therapy.

Peri-implant mucosal enhancement using leukocyte platelet rich fibrin under Sohn's poncho technique: A randomized controlled clinical trial.

BACKGROUND: A biological seal that protects the implant from any biological or external impingement is created by the supracrestal attached tissues. Sohn's poncho technique is a technique that utilizes a healing abutment at the implant site to stabilize the platelet rich fibrin (PRF) membrane. Thus, the aim of this study is to evaluate the efficacy of Sohn's poncho technique used for placement of leukocyte PRF (L-PRF) membrane in improving the peri-implant mucosal thickness and width of keratinized mucosa as well as in the acceleration of healing process compared to the peri-implant mucosa surrounding healing abutments placed without the L-PRF membrane. METHODS: A split mouth randomized controlled clinical trial was designed in which implants were placed in the mandibular posterior region. Healing abutment is placed along with the L-PRF membrane at the test site using Sohn's poncho technique and at control site conventional healing abutment placement was done at second stage. The thickness of peri-implant mucosa as primary outcome and the Width of keratinized tissue and healing as secondary outcomes were measured and assessed at various time intervals. RESULTS: Statistically significant difference was seen in inter-group analysis when peri-implant mucosal thickness (3.8 ± 0.4 mm vs. 2.3 ± 0.4 mm) and width of keratinized mucosa (3.6 ± 0.6 mm vs. 2.7 ± 0.3 mm) in test and control groups respectively and intragroup analysis of test and control groups at 4 weeks and 6 weeks' time points. The control group showed faster healing when compared to the test group. CONCLUSION: Sohn's poncho technique in combination with L-PRF has the potential to improve the thickness of peri-implant mucosa and the width of keratinized mucosa around implants.

Role of Medicinal Herbs in Periodontal Therapy: A Systematic Review.

Aims and Objectives: The use of medicinal herbs to prevent gingival and periodontal diseases has become increasingly popular due to their anti-inflammatory and antioxidant properties. This systematic review aims to provide the current literature to validate the traditional use of medicinal herbs in the management of gingival and periodontal diseases. Materials and Methods: An online literature search was conducted to identify research papers published from 2010 to 2022 in three major scientific databases, PubMed, Scopus, and Web of Science, in June 2022. Original research studies, case reports, and systematic reviews on medicinal plants' application in oral health care were selected to be included in this systematic review. Only high-quality articles identified in the quality assessment were included for evidence synthesis. Results: Initial keyword research yielded 726 free-text articles published between 2010 and 2022. Of these, 14 articles (8 research papers and 6 reviews) were included for evidence synthesis. The review's findings indicate that the antibacterial property of medicinal plants is due to their alkaline nature and prevents plaque and calculus formation by maintaining acid-alkali balance in saliva. Various parts of medicinal plants help maintain periodontal health. Glycyrrhiza glabra, Ficus religiosa, and Plantago major effectively inhibit primary plaque colonizers and periodontal pathogens. Medicago sativa, Aloe barbadensis Miller, and Trifolium pratense have excellent applications in treating periodontal diseases. Mangifera indica, Pongamia pinnata, the husk of Cocos nucifera, the root of G. glabra and Curcuma longa, leaves of Psidium guajava and Azadirachta indica, fruits of Citrus medica and Punica granatum, Ocimum Moringa oleifera extract, and pomegranate peel extract can serve as a promising alternative in managing chronic gingivitis. Conclusion: The anti-inflammatory, antioxidant, antibacterial, and astringent action of extracts obtained from various parts of medicinal plants make them effective in reducing gingival and periodontal diseases. Herbal medicine may be a viable alternative to contemporary pharmaceuticals as an adjuvant to scaling and root planning procedures.

Electromyographic evaluation of masseter and temporalis muscle activity after periodontal surgery: A prospective clinical trial.

Objectives: Following periodontal treatment, tooth supporting structures are restored to functionality and hence improve muscle activity. In this study, we aimed to investigate the influence of periodontal disease on muscle activity by electromyography and the subjective perception of periodontal therapy through the Oral Impact on Daily Performance (OIDP) questionnaire. Methods: Sixty subjects with moderate to severe periodontitis were included. Periodontal condition was re-evaluated 4-6 weeks after non-surgical periodontal therapy (NSPT). Subjects with persistent probing pocket depths ≥5 mm were designated for flap surgery. All clinical parameters were recorded at baseline, 3 months and 6 months after surgery. The activities of the masseter and temporalis muscles were measured by electromyography and OIDP scores were recorded at baseline and 3 months. Results: The mean plaque index scores, probing pocket depths, and clinical attachment levels were reduced from baseline to 3 months. Mean EMG scores were compared at baseline and 3 months post-surgery. The mean OIDP total score prior to and after periodontal therapy was significantly different. Conclusion: There was a statistically significant correlation between clinical parameters, muscle activity and a patient's subjective perception. Therefore, it can be concluded that successful periodontal flap surgery led to improvements in masticatory efficiency and subjective perception, as determined by the OIDP questionnaire.

Clinical outcomes of root coverage using porcine-derived collagen matrix with modified coronally advanced tunnel technique (MCAT) in multiple gingival recessions in smokers - a randomized controlled clinical trial.

OBJECTIVES: Root coverage (RC) is an integral part in management of gingival recessions. Unlike isolated recessions, treating multiple recessions is the most challenging scenario especially in smokers who have reported reduced RC in terms of quantity and stability. Modified coronally advanced tunnel (MCAT) technique due to its improved vascularity along with use of porcine-derived collagen matrix (PDCM) (Mucograft™) with its bilayered dense collagen matrix may be a predictable alternative to conventional gold standard subepithelial connective tissue graft (SCTG). The purpose of this study was to compare the results of RC achieved using PDCM and SCTG with the MCAT approach in the treatment of multiple gingival recessions in smokers. METHODOLOGY: This is a prospective randomized controlled clinical study registered under clinical trial registry (CTRI no. CTRI/2020/03/024238) including 28 patients with 64 recession defects. Smokers (≥ 10 cigarettes/day for ≥ 5 years) fulfilling the inclusion criteria were randomized into the SCTG and PDCM groups which were treated with SCTG using MCAT and PDCM using MCAT technique, respectively. Recession depth (RD), recession width (RW), width of keratinized tissue (WKT), thickness of keratinized gingiva (TKG), and %RC were assessed at baseline, 3, and 6 months. Complete RC (CRC) at 3 and 6 months, RC aesthetic scores (RCES) at 6 months. RESULTS: Both groups showed significant improvement in all clinical parameters. Intergroup comparison of root coverage parameters in smokers showed better performance of the PDCM group in terms of RD, %RC, TKG, WKT, CRC (45.06%), and RCES (p < 0.001) compared to the SCTG group. Time taken for surgical procedure and visual analog pain scores were significantly lesser in the PDCM group. CONCLUSION: PDCM showed good predictable results in terms of all RC parameters compared to SCTG and thus may be used as a predictable alternative to SCTG for RC in smokers. CLINICAL SIGNIFICANCE: PDCM can be used as a potential alternative to gold standard subepithelial connective tissue graft in smokers with better patient compliance.

Systematic Reviews in Dental Research: A Bibliometric Analysis of Contribution from Indian Dentists During 1948-2022.

Aims and Objective: Although systematic reviews (SRs) are the backbone of evidence-based dentistry, they have appeared infrequently in dental literature and their importance may not be recognized by dentists. So, this study aimed to identify SRs in dental research contributed by Indian dentists to the PubMed database during 1948-2022 and describes their epidemiological and descriptive characteristics. Materials and Methods: An electronic search of the PubMed database was performed from 1948 through September 2022. SRs were considered for inclusion if they were related to oral health and published by Indian dentists as the first author. From this collection, the following characteristics of SRs were described: name of the journal, type of journal (e.g., general dentistry, specialty dentistry, non-dental), year of publication, author's affiliation, and focus of the SR. Results: The search identified 439 SRs in dentistry indexed in the PubMed database during 1948-2022. There were only 5 SRs published from 2007 to 2010 with maximum publications during the year 2021 (n = 114; 25.97%). About 32.35% of the SRs (n = 142) were published in 10 journals with the maximum contribution from the Journal of Conservative Dentistry (n = 22; 5.01%). The majority of the SRs were published in the field of Pedodontics and Preventive Dentistry (n = 72; 16.40%), followed by Conservative Dentistry and Endodontics (n = 63; 14.35%). Conclusion: The contribution of SRs in dental research from India is small but growing. There is a clear need to improve SRs in dental research qualitatively and quantitatively.

Comparison of clinical and radiological outcomes using crestal approach sinus kit and piezoelectric surgery for sinus membrane elevation: A prospective clinical trial.

Background: To overcome the drawbacks of sinus floor augmentation procedures newer surgical techniques to reduce sinus perforation such as crestal approach sinus kit (CAS) and piezosurgery, which are minimally invasive procedures enabling uncomplicated sinus elevation have evolved. The aim of the present study was to investigate the performance of CAS kit compared to piezosurgery during maxillary sinus membrane elevation. Materials and Methods: A total of 40 subjects requiring maxillary sinus membrane augmentation for rehabilitation with implant prosthesis in posterior maxilla were included in the study. The current study was a prospective clinical trial where osteotomy and sinus elevation was done using CAS kit in Group 1 and piezosurgery in Group 2. Platelet-rich fibrin was placed in osteotomy site and dental implants were inserted. Implant stability was evaluated at baseline and 3 months. Crestal bone loss was measured at 3, 6, and 12 months. Apical bone gain was measured at 6 and 12 months. Intragroup comparison of the study groups was done by Paired t-test, ANOVA test, and Friedman test. Intergroup comparison was done by unpaired t-test and Mann-Whitney U-test. P < 0.05 was considered statistically significant. Results: Implant stability improved in both the groups, i.e., 79.2 ± 5.02 and 79 ± 5.31 in Group 1 and Group 2, respectively, at 3 months. Intergroup comparison showed no difference in all parameters; however, crestal bone loss was greater in piezosurgery group with a mean difference of 0.74 mm. Conclusion: Both CAS and piezosurgery groups showed definitive improvement in all parameters. CAS group resulted in added benefits in terms of less crestal bone loss and intraoperative surgical time compared to piezosurgery group.

Soft and Hard Tissue Revision Around an Implant: Case Report with a 10-Year Follow-up.

Dental implants are the most promising modality of tooth replacement in the modern era. Of late, peri-implant architecture has gained significant importance and forms the basic foundation for success of an implant restoration, with both the hard and soft tissue components around an implant playing vital roles in the osseointegration process. A 23-year-old man reported with a titanium membrane exposure around tooth site 16 (FDI tooth-numbering system) along with decreased attached gingival width and thickness. To gain soft tissue thickness, a rotated connective tissue graft was harvested, as was a "sticky bone" graft to gain bone volume. Connective tissue is one of the most promising modalities for soft tissue augmentation around both the natural tooth and implants. "Sticky bone," which is a more advanced form of bone grafting techniques, was implemented to achieve the benefits of injectable platelet-rich fibrin. This case report describes the hard and soft tissue augmentation procedure and successful results at the 10-year follow-up, as well as fabrication of an implant-supported fixed partial denture.

Emotional Health Status of Postgraduate Students of Periodontics in India During COVID Health Crisis-A Questionnaire-Based Study.

Dental students, especially postgraduate students present a higher risk of getting infected because of their close contact with the patients during this pandemic. The objectives of the study include (a) the reasons for postgraduate students' altered emotional status during coronavirus (COVID-19) infection. (b) To assess the kind of infection protocols adopted. (c) To assess the impacts of postgraduate students' emotional status on treating patients with periodontal problems during the COVID-19 lockdown period from March 2020 to December 2020. The emotional status of postgraduate students was assessed in 2 phases that are at the initial phase of COVID infection and lockdown and the second phase when the lockdown was prolonged. Questionnaires were distributed to the Postgraduate students of periodontics all over India to assess their level of awareness of COVID infection, type of infection control measures followed during the pandemic period, as well as the outpatient turnout during the lockdown period. Results of this study stated that more than 80% of students addressed the decline in the number of patients to surgical clinics, 76.3% of postgraduates were worried about themselves and their families due to the pandemic situation. Surprisingly, 74.3% of them even worried about losing their expertize or skills due to a long lockdown period. Dental postgraduates all over India are willing to treat their patients during the period of a pandemic but in strict compliance with infection control guidelines. This study assessed the emotional responses of the postgraduates during the pandemic through the questionnaire and concluded that all the professionals are ready to resume their clinical activities with adequate guidelines provided.

Assessment of knowledge, attitude, and practice related to ergonomics among the students of three different dental schools in India: An original research.

BACKGROUND AND OBJECTIVE: Dental students and practitioners are frequently prone to work-related musculoskeletal disorders (WMSDs) due to the unawareness of ergonomic principles when practicing dentistry. The aim of this study was to assess the dental student knowledge, attitude, and practice toward ergonomics in three different dental schools. METHODOLOGY: A cross-sectional study was conducted among 1166 dental students from three different dental schools of Andhra Pradesh, India, to assess knowledge, attitude, and practice regarding ergonomics. All the participants were provided with prestructured questionnaire form comprising 13 questions to know their knowledge, attitude, and practice related to ergonomics before and after providing guidelines on ergonomic principles. RESULTS: The majority of the dental students appreciate that the most affected regions due to work-related disorders were back (475 before and 559 after instructions), neck (354 and 420), hand and wrist (205 and 117), and shoulder and elbow (132 and 70), respectively. Knowledge and practice scores of dental students (mean and standard deviation) regarding WMSDs before and after applying ergonomic principles were 3.92 ± 2.44, 1.29 ± 1.67 and 5.81 ± 0.87, 3.03 ± 0.60, respectively. CONCLUSION: The present study provides an insight into ergonomics for dental students during routine dental procedures. The knowledge, attitude, and practice related to ergonomics were satisfactorily increased among the participants. Thus, ergonomic education of the dental health-care personnel must be focused in all the educational institutions and at continuing dental health programs by delivering ergonomic principles both theoretically and practically and should be a part of the curriculum.

Effect of e-learning methods on Dental education: An observational study.

BACKGROUND: The progress in the usage of technology in hardware, software, and cost-effective Internet connectivity enable the availability of science-related information and its usage in all the developing countries. Hence, in this practical world, there should be a need to implement effective and affordable dental education strategies to attain oral health for all in the coming years. OBJECTIVE: The aim of this study is to reduce the need to teach theory-based, on-site classes, e-learning came into existence. E-learning for dental education may alleviate the burden of severe health worker shortages and deliver affordable access to high-quality dental education. METHODOLOGY: Evaluation and assessment methods were done to know the effectiveness of e-learning in dental education by conducting continuing dental education on newer materials and methods, assignments/formative assessments and by open discussions of case descriptions and their treatment modalities through Edmodo app in our dental institute. Effect on knowledge, skills, attitudes, and satisfaction levels of dental students compared to other traditional methods. RESULTS: Dental e-learning has the capacity to develop into a leading-edge to strengthen clinical training skills among dental students by conducting continuing dental education, assignments, formative assessments, case descriptions, and their treatment modalities through e-learning are the best ways to improve quantity and quality in dental education. CONCLUSION: The probable prospective of e-learning could be innovative or revolutionary because this helps in both theoretical-related and clinical-related advancements, and it is possible only with e-learning in developing countries to meet the quality in education.

Role of Orthoboon (glucosamine sulfate + collagen + Vitamin C): A novel host-modulating agent in the management of chronic periodontitis.

BACKGROUND: Recent trends suggest using novel host-modulating agents as a treatment strategy for chronic periodontitis. Glucosamine sulfate (GS) was proven to have anti-inflammatory actions related to its ability to suppress neutrophil functions. Orthoboon, an anti-arthritic and anti-inflammatory drug, has shown to have a positive therapeutic effect due to its constituents made of a combination of GS, Vitamin C, and collagen. The aim of the study was to evaluate the host modulatory effects of Orthoboon on periodontal status and to estimate the C reactive protein (CRP) levels before and after nonsurgical periodontal therapy (NSPT). MATERIALS AND METHODS: A total number of 40 patients with chronic periodontitis were randomly divided into two groups of 20 patients each. The test group patients (n = 20) received 500 mg Orthoboon three times daily for 45 days. Prior to the initiation of Orthoboon, all patients in both test group and control group were subjected to Phase I periodontal therapy. CRP levels were estimated immediately after phase I therapy and 45 days after therapy. Clinical parameters including plaque index, gingival index, and bleeding index were recorded before and after NSPT for the two groups. RESULTS: The mean CRP levels were reduced significantly in the test group before and after administration of Orthoboon and also there were statistically significant differences in the mean CRP levels at the end of 45 days between the test group and the control group. CONCLUSION: Administration of Orthoboon, i.e., GS, with a combination of Vitamin C and collagen was proved to be of a significant benefit in the test group than in the control group.

Evaluating the efficacy of different magnification variables during root planing procedure under a surgical operating microscope in chronic periodontitis: A randomized clinical trial.

BACKGROUND: The journey in the field of periodontics has destined from macrodentistry to microdentistry. The success of periodontal therapy always depends on better visual access and debridement which are prerequisites for achieving a clean and smooth root surface in attaining new attachment. Magnification is something which provides good hand-eye coordination resulting in better treatment outcomes. The aim of our study is to assess the effectiveness of magnification variable under a surgical operating microscope while performing root planing procedure. MATERIALS AND METHODS: A randomized clinical trial was conducted on 45 patients who were diagnosed with mild-to-moderate chronic periodontitis and were treated under the surgical operating microscope with three different magnification variables (0.4, 0.6, and 1). Plaque index, gingival index (GI), and probing pocket depths (PPDs) were assessed from baseline to 4 weeks, whereas healing index was assessed after 2 weeks of root planing procedure. RESULTS: The results of our study under the three magnification variables (0.4, 0.6 and 1) have shown no significant reduction in plaque or GI after 4 weeks of therapy. However, a significant reduction PPDs was observed after 4 weeks and improved healing index was observed after 2 weeks under all the three magnification variables with the variable 0.6 demonstrating more effective results. CONCLUSION: Even though all the three magnification variables have shown better treatment outcome and ergonomics, 0.6 magnification variable, i.e., ×3.5 - ×5, has demonstrated a more significant effect while performing root planing procedure.

Analysis of Plasma Homocysteine Levels in Patients with Chronic Periodontitis Before and After Nonsurgical Periodontal Therapy Using High-Performance Liquid Chromatography.

INTRODUCTION: Homocysteine (Hcy), an inflammatory biomarker, is a sulfur-containing amino acid. Elevated levels of plasma Hcy are evident in various inflammatory conditions and have been described as an independent risk factor for cardiovascular disease. The literature has also stated that a similar association could exist between the chronic periodontitis and plasma-Hcy levels, in otherwise systemically healthy individuals. However, studies on Hcy levels in periodontitis are scarce. Hence, this study aimed to assess the levels of plasma Hcy in patients with chronic periodontitis before and after nonsurgical periodontal therapy. MATERIALS AND METHODS: This longitudinal, case-control clinical study included a total of 60 patients who were divided into two groups. Periodontal parameters including Plaque Index, Gingival Index, Sulcus Bleeding Index, probing depth, and clinical attachment level were recorded at baseline and 12 weeks after periodontal therapy. A high-performance liquid chromatography analysis was performed to measure the Hcy levels. The results were evaluated statistically for intergroup pair-wise comparisons by Mann-Whitney U-test and intragroup comparison by Wilcoxon-matched pairs test. Correlation between the plasma-Hcy levels with other clinical parameters in all groups was done by Spearman's rank correlation method. RESULTS: The Hcy was detectable in all the samples. At baseline, the mean levels of plasma Hcy were found to be low in the control group, whereas in the test group, it is found to be higher. These plasma-Hcy levels and all periodontal parameters were reduced significantly after nonsurgical periodontal therapy. CONCLUSION: The results demonstrated that plasma-Hcy levels are reduced after nonsurgical periodontal therapy but not to the levels comparable with those found in healthy individuals. Therefore, nonsurgical periodontal therapy may be used as an adjunctive Hcy-lowering therapy, contributing toward primary prevention against cardiovascular diseases.

Efficacy of Ocimum sanctum, Aloe vera and chlorhexidine mouthwash on gingivitis: A randomized controlled comparative clinical study.

BACKGROUND: The medicinal plants are widely used for curing various diseases in day-to-day practice. Ocimum sanctum (Tulsi) is one such popular herb in Ayurvedic medicine, which is widely used in the treatment of several systemic diseases because of its antimicrobial property. Aloe vera is also widely known for its medicinal uses in wound healing and its anti-inflammatory properties. However, studies documenting the effect of O. sanctum and A. vera in treating gingivitis are rare. AIM: The aim of this study was to assess the effectiveness of two herbal mouthwashes in comparison with chlorhexidine mouthwash on gingivitis. MATERIALS AND METHODS: A double-blind randomized placebo-controlled clinical trial, wherein sixty patients were randomly allocated into three study groups. (1) O. sanctum mouthwash (n = 20) (2) A. vera mouthwash (n = 20) and (3) Chlorhexidine mouthwash (n = 20). All groups were treated with scaling and asked to rinse with respective mouthwashes twice daily for 1 month. Clinical parameters such as plaque index (PI), gingival index (GI), and sulcus bleeding index (BI) were recorded at baseline, after 15 days and after 30 days, respectively. RESULTS: Results of the study showed that O. sanctum, A. vera and chlorhexidine are equally effective in reducing plaque, gingival, and bleeding indices at 30-day interval. However, no significant reductions in PI, GI and BI in 15-day interval in group 1 and group 2 when compared with chlorhexidine were evident. CONCLUSION: The results in the present study indicate that O. sanctum and A. vera may prove to be as effective as chlorhexidine mouthwash in its ability in reducing all the three indices by reducing plaque accumulation, gingival inflammation and bleeding when used in the long-term follow-up.

Melanocyte Response Following Depigmentation by Cryosurgery and Mucosal Excision: A Comparative Clinical and Histopathological Study.

AIMS: The main aim of this study was to evaluate the melanocyte response following depigmentation by cryosurgery and mucosal excision at both clinical and histopathological levels during 6 months. SUBJECTS AND METHODS: A total of 15 individuals, aged 25-45 years with hyperpigmentation on the facial aspect of the gingiva present in the esthetic zone were included. A split-mouth approach was used, wherein one side received depigmentation by a scalpel and the other side received cryotherapy, with the choice of the therapy and side chosen by the spin of the coin. For determining the melanocyte assay, a small amount of gingival tissue that was excised was studied under a special staining technique, i.e., Masson-Fontana method for melanin, a histochemistry procedure which determines the activity of melanin both quantitatively and qualitatively. Clinical and histological observations for the intensity of pigmentation were recorded at baseline and 6 months after surgery. STATISTICAL ANALYSIS USED: Paired and unpaired t-test. Results: The mean value of the Dummett Oral Pigmentation Index (DOPI) was 2.44 ± 0.51 at baseline; following depigmentation with scalpel technique, the mean DOPI was 1.05 ± 0.23 at 6 months; and there was a statistically significant difference in the mean DOPI when compared with that of the baseline (P = 0.001). Following depigmentation with cryosurgery technique, the mean DOPI was 0.33 ± 0.48 at 6 months which also varied statistically significantly with that of the baseline (P = 0.001). The mean value of melanin histopathological count (MHC) was 95.53 ± 9.03 at baseline; following depigmentation with the scalpel technique, the mean DOPI was 89.49 ± 7.56 at 6 months, which was not statistically significant (P = 0.795). Following depigmentation with the cryosurgery technique, the mean MHC was 75.38 ± 5.63 at 6 months, which was not statistically significant (P = 0.285). CONCLUSIONS: The mean histologic count of the melanocytes, which accounts for the re-pigmentation process has shown low recurrence values in cryosurgery over the scalpel technique even though the difference was not statistically significant.

Comparative Evaluation of Triphala, Aloe vera, and Chlorhexidine Mouthwash on Gingivitis: A Randomized Controlled Clinical Trial.

AIM: The aim of this study was to assess the effectiveness of two herbal mouthwashes in comparison with Chlorhexidine mouthwash on gingivitis. MATERIALS AND METHODS: This is a triple-blind randomized controlled clinical trial, where in 60 patients were randomly allocated into three study groups: Triphala mouthwash (Group A), Aloe vera mouthwash (Group B), and Chlorhexidine mouthwash (Group C). All groups were treated with scaling and asked to rinse with respective mouthwashes twice daily for 1 month. Clinical parameters such as plaque index (PI), gingival index (GI), and bleeding index (BI) were recorded at baseline, 15 days, and 30 days, respectively. RESULTS: Our results suggested that Triphala group effectively demonstrated a higher reduction in GI and BI index scores compared to A. vera group (P ≤ 0.005) and the effect is equivocal to the reduction seen with Chlorhexidine group. However, no statistically significant difference was observed between the mouthwashes in reduction of PI scores (P > 0.005). CONCLUSION: The results of our study evidenced Triphala to be superior in the reduction of plaque, gingival inflammation, and bleeding compared to that of A. vera. However, the results of our study also indicated that Triphala was as effective as chlorhexidine mouthwash in its ability in reducing plaque accumulation, gingival inflammation, and bleeding. Furthermore, Triphala is relatively free of side effects compared to that of chlorhexidine.

Salivary visfatin concentrations in patients with chronic periodontitis: An analysis before and after periodontal therapy.

BACKGROUND AND AIMS: Visfatin, also known as pre-B-cell colony enhancing factor, is secreted from a variety of cells and is thought to have some proinflammatory and immunomodulating effects. It is indicated that serum/plasma levels of visfatin increase in a number of inflammatory disorders. The present study aims to assess salivary visfatin concentrations and investigate its relationship in patients with chronic periodontitis before and after periodontal therapy. METHODS: This prospective clinical study included a total of 20 subjects who were divided into two groups with 10 patients in each viz Group A: Periodontally healthy subjects, Group B: Chronic periodontitis subjects. In group B, the subjects were further assigned as T1 and T2 groups before and after periodontal therapy. Periodontal parameters including plaque index, gingival index, sulcus bleeding index, probing depth and clinical attachment level were recorded at baseline and patients were subjected to periodontal therapy. An ELISA analysis was performed to measure the visfatin levels in saliva in study groups before and after 12 weeks of periodontal therapy. STATISTICAL ANALYSIS USED: The results were evaluated statistically using Student t-test, one way ANOVA, Post-hoc Tukey's test and Pearson's rank correlation method. RESULTS: The salivary visfatin concentrations were reduced significantly after periodontal therapy. There were statistically significant differences elicited in salivary visfatin levels of Group A and T1 of Group B and also between T1 and T2 of Group B. CONCLUSIONS: Salivary levels of Visfatin are reduced after periodontal therapy to the levels comparable with those found in healthy individuals. Therefore, the salivary visfatin levels may have the potential to be a target marker for assessment of responses to periodontal therapy.